Hepatic falciform artery - Angiographic findings in 25 patients

Purpose: To determine the frequency of hepatic falciform artery (HFA) occur rence on celiac or hepatic angiograms and elucidate the anatomy and clinica l importance. Material and Methods. Among 1,250 patients who underwent celiac or hepatic arteriography, we encountered 25 patients (2%) with a HFA. Prospectively, C T hepatic falciform arteriography (CTHA) was performed in 4 patients. Indig ocarmine dye was injected into the HFA in 6 patients to evaluate whether th e abdominal skin was stained. Embolization of the HFA before chemoembolizat ion for hepatocellular carcinoma was performed in 4 patients to prevent abd ominal wall injury. Results: Among 25 patients, the HFA arose as a terminal branch of the middl e hepatic artery in 14 patients (56%) and of the left hepatic artery in 11 patients (44%). The vessel was single in 18 patients (72%) and double in 7 patients (28%). Two vessels ran side by side along the hepatic falciform li gament. On CTHA, the HFA ran within the hepatic falciform ligament and the branches were connected with the liver around the hepatic falciform ligamen t. After indigocarmine dye injection, the stain of abdominal skin was recog nized in all 6 patients. No abdominal wall injury occurred in any of the 4 patients who were subjected to hepatic chemoembolization. Conclusion. HFA is an extrahepatic pathway which runs to the abdominal wall . Before chemoembolization of the middle or left hepatic artery for hepatic malignancy the HFA should be recognized.